tanzania national family planning costed implementation program (nfpcip) 2010-2015
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Tanzania National Family Planning Costed Implementation Program (NFPCIP)2010-2015
Presentation Outline
Our Reproductive Health Situation
Issues and Challenges in Family Planning
NFPCIP – Rationale, Development Process, Strategic Objectives, and Funding Estimates
Next Steps: From Planning to Action
RH Situation
A Consistently High Fertility Rate
6.35.8 5.6 5.7
0
1
2
3
4
5
6
7
1991–92 1996 1999 2004–05
Year
Fert
ilit
y r
ate
(ave
rage n
um
ber
of
child
ren p
er
wom
an)
45% under the age of 15
A Young Population soon to be in their reproductive years . . .
-10% -8% -6% -4% -2% 0% 2% 4% 6% 8% 10%
Male Female
Percent of the population
80 +75-7970-7465-6960-6455-5950-5445-4940-4435-3930-3425-2920-2415-1910-14
5-90-4
0 4810 2 6 86 4 2 10
Ag
e in
ye
ars
529578
193
0
100
200
300
400
500
600
700
1999 2004 2015
Yr
MM
R
Target by 2015
Persistent High Maternal Mortality Ratio
Total Demand and Unmet Need for FP
0
10
20
30
40
50
60
1992 1996 1999 2004
Unmet Need
Total Demand
Increasing Demand and Constantly High Unmet Need
A Slowly Rising Modern CPR
713
1720
0
10
20
30
40
50
1991–92 1996 1999 2004–05
Year
Mo
dern
co
ntr
acep
tive u
se
Key Issues and Challenges Facing Family Planning
Declined Annual CPR Growth Rate Over Time
Declining Annual Percentage Growth Rate
1.4
0.6
0
0.2
0.4
0.6
0.8
1
1.2
1.4
1.6
1992 - 1999 1999 - 2004
Program Attributes during the Golden era
Heavy Donor Support – Direct Funding
Centrally Managed Vertical National Program
Strong National Communication Campaign – Green Star
Well executed National FP Training Strategy
Active Engagement of NGOs/FBO in Service Delivery
Strong National CBD Program
What Happened?
Global Factors Reduced Donor Support
Sector Reforms - Shift from Direct to Basket Funding- Decentralization - Integration in RCH
Competing Health Priorities- HIV/AIDS- Infant deaths- Malaria
Considerably Underfunded
Program
Issues and Challenges (1)
Contraceptive Security: Contraceptive availability not meeting current demand
Method Mix highly composed of short-acting methods which raise costs considerably
Human Resources:
Critical Shortage of Human Resources - 35% capacity
Inadequate number of providers with updated/optimal FP training
Knowledge-Use Gap: High level of awareness of FP does not equal use of FP services
Issues and Challenges (2)
Service Delivery Systems Infrastructure Limitations to offer accessible and
comprehensive FP services
Missed Opportunities as a results of inadequate integration with other health services
Functioning community-based distribution confined to very few areas
Social Marketing program limited to few methods – pills and condoms
The NFPCIP Rationale, Development Process and
Strategic Objectives
Renewed Focus on MNCH
The National Road Map To Accelerate Reduction of Maternal, Newborn and
Child Deaths in Tanzania2008 - 2015
Rationale for the NFPCIP
Goal: Increase Contraceptive Prevalence Rate to 60% by 2015
Annual Percentage Growth Rate
1.4
6
0.6
0
1
2
3
4
5
6
7
1992 - 1999 1999 - 2004 2010-2015
Repositioning Efforts
Advocacy at various levels
Re-establishment of the National FP Working Group in 2008
Nationwide training efforts
Enhanced Social Marketing
Increasing role of Private sector
Missing Link?!
Missing Link?!
Overview of the NFPCIP
Costed strategic actions that sets direction on what needs to be done to achieve the national target
Call for a Renewed Commitment, Partnership and Coordination among all partners to reposition FP
Participatory & Consultative Development Process
Development Process Overview & Timeline
PHASE I: Gathering and
Synthesizing Information
PHASE II:Planning and Drafting the Plan
PHASE III:Production and Launch
March 2009
March 2010
June2009
Purpose of the NFPCIP
1. Strengthen FP as a priority area in the National Development Agenda
2. Understand the budgetary needs to implement a FP program to reach projected targets
3. Mobilize and sustain quality resources
4. Prioritize FP program strategic actions for implementation
5. Provide benchmarks and indicators to monitor and support the FP program
Strategic Objectives
Contraceptive Security
Capacity building of providers
Strengthened service delivery systems
Advocacy and Demand Generation
Strengthened health systems management
Cost Estimates by Strategic Area (In USD$)
Strategic Action Area TotalPercentage
Of Total Budget
Contraceptive Security & Logistics 89,873,499 91%
Capacity Building 4,210,132 4%
Service Delivery 2,105,818 2%
Advocacy 1,639,993 2%
Management Systems/ M&E 830,541 1%
Total ( In USD$) 98,659,985
***Central Budget Only
Cost Estimates by Year (In USD$)
Year USD$
FY 2010-2011 14,547,160
FY 2011-2012 15,493,092
FY 2012-2013 15,602,217
FY 2013-2014 16,041,735
FY 2014-2015 17,513,809
FY 2015-2016 19,461,971
Key Points - Resource Estimates
Central Government Budget
Local Government (District) Budget
NFPCIP
CCHP
Key Points - Resource Estimates (2)
Not Included: Salaries for Human Resources and Infrastructure costs Equipment and Supplies except for Commodities District Level Budget
Areas of Priority Focus: Meet Current Demand by Strengthening Supply System Implement integration of FP Service delivery across the health
sector Address knowledge-use gap issues Implement sustainable measures to practical approaches such
as CBD of FP, demand generation
Next Steps: Planning to Action
By July 2010, Performance Monitoring Plan- Resource Mobilization- Program Implementation Progress
Quarterly Progress Reporting to MOHSW Management
Revisiting Terms of Reference of National FP Working Group
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